Depressive Mood and Subsequent Cancer Diagnosis in Patients Undergoing a Colonoscopy

• Published in: Psychosomatics (Washington, D.C.) D.C.), 2012-07, Vol.53 (4), p.356-362
• Main Authors: Abgrall-Barbry, Gaëlle, M.D, Lemogne, Cédric, M.D., Ph.D, Lamarque, Dominique, M.D, Leuret, Bérengère, Bydlowski, Sarah, M.D, Jian, Raymond, M.D., Ph.D, Dantchev, Nicolas, M.D., Ph.D, Consoli, Silla M., M.D., Ph.D
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Anemia - epidemiology; Biological and medical sciences; Colonic Polyps - epidemiology; Colonic Polyps - genetics; Colonic Polyps - pathology; Colonic Polyps - psychology; Colonoscopy - psychology; Colonoscopy - statistics & numerical data; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - genetics; Colorectal Neoplasms - psychology; Comorbidity; Cross-Sectional Studies; Delayed Diagnosis; Depression; Depression - epidemiology; Female; Genetic Predisposition to Disease; Guideline Adherence; Humans; Internal Medicine; Male; Medical sciences; Middle Aged; Mood disorders; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sex Distribution; Weight Loss - physiology
• ISSN: 0033-3182; 1545-7206
• DOI: 10.1016/j.psym.2012.01.001

Background In patients with clinical signs that may indicate a colorectal cancer, physicians may interpret the presence of a comorbid depressive mood as either increasing or decreasing the likelihood of cancer diagnosis. This study examined the association between depressive mood in candidates for a colonoscopy and subsequent diagnosis of cancer. Methods Ninety-four outpatients [35 men, mean age ± standard deviation (SD) = 56.2 ± 9.8 years, 59 women, mean age ± SD = 54.2 ± 12.9 years] were given the 13-item Beck Depression Inventory to assess depressive mood before undergoing a colonoscopy. Additional psychological, demographic, and clinical data were collected prior to the colonoscopy. Results The colonoscopy found a cancer in 18 patients (19.1%). Cancer patients were older (P = 0.015) and more likely to present with anemia (P < 0.001) and unexplained weight loss (P = 0.046). Depressive mood was associated with a subsequent diagnosis of cancer in women (P = 0.007), but not in men (P = 0.985). This association remained significant after adjustment for potential confounders in women (i.e. anemia and unexplained weight loss) (P = 0.014). Conclusions In women with clinical signs that warrant a colonoscopy, comorbid depressive mood may be associated with an increased likelihood of colorectal cancer and should not delay the receipt of a guideline-based diagnosis procedure.